Kidney Health Biomarkers and Estimated Glomerular Filtration Rate Among Indonesian Tofu Production Workers: A Pilot Cross-Sectional Study.
5 affiliations
- 1Department of Occupational Safety and Health Faculty of Public Health, Universitas Airlangga Surabaya Indonesia.
- 2Occupational Health and Safety Management Research Group, Faculty of Public Health Universitas Airlangga Surabaya Indonesia.
- 3Master Programme in Occupational Health and Safety, Faculty of Public Health Universitas Airlangga Surabaya Indonesia.
- 4Department of Health Sciences Faculty of Humanities and Health Sciences, Curtin University Malaysia Miri Malaysia.
- 5Research Fellow of Occupational Safety and Health Department, Faculty of Public Health Universitas Airlangga Surabaya Indonesia.
Abstract
Small-scale food-production workers may experience heat strain, dehydration, and combustion-related exposures, but evidence on early kidney injury in these settings remains limited. This pilot study aimed to describe serum and urinary kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) profiles and to assess, exploratorily, whether these biomarkers discriminated an estimated glomerular filtration rate (eGFR)-defined kidney-function category among Indonesian tofu production workers. A cross-sectional complete-case analysis included 32 workers from small-scale tofu production units in East Java, Indonesia. Serum creatinine, serum and urinary KIM-1, and serum and urinary NGAL were measured using laboratory microplate-based assays. eGFR was calculated using the CKD-EPI creatinine equation; < 90 mL/min/1.73 m2 was a study-defined exploratory category, not a CKD diagnosis. Descriptive statistics, Mann-Whitney U tests, Spearman correlations, and receiver operating characteristic analysis with 2000-resample bootstrap 95% confidence intervals were performed. Ten of 32 workers (31.3%) had eGFR < 90 mL/min/1.73 m2, and four of 32 (12.5%) had serum creatinine above the laboratory threshold. Median KIM-1 and NGAL concentrations were lower in the eGFR < 90 group across all four biomarker measures. Discriminatory performance was limited, with area-under-the-curve values ranging from 0.327 to 0.416. Urinary KIM-1 and NGAL were analysed as absolute concentrations without urinary creatinine normalisation; hydration-related variation in urine concentration may have increased measurement variability and weakened observed associations and discrimination. With 32 workers and 10 eGFR < 90 observations, the AUC estimates are imprecise and not definitive measures of diagnostic performance. KIM-1 and NGAL showed limited discrimination of the study-defined eGFR < 90 category; this result does not indicate poor overall utility as tubular injury biomarkers. Larger exposure-informed studies should incorporate creatinine-normalised urinary biomarkers, albuminuria, repeated kidney-function measurements, and objective assessment of heat and nephrotoxic exposures.
Related
- Non-invasive assessment of estimated glomerular filtration rate using lens autofluorescence in a population without chronic kidney disease
- Anemia and Red-Cell Size Across Estimated Glomerular Filtration Rate in a Hospital Laboratory Cohort
- Meeting a Proposed Estimated Glomerular Filtration Rate Slope-Based Criterion for Clinical Remission of Chronic Kidney Disease During Sequential Kidney-Protective Therapy in Type 2 Diabetes Mellitus: A Case Report
- Association Between Admission Estimated Glomerular Filtration Rate and Long-Term Mortality in Patients with Acute Myocardial Infarction
- Association of Finerenone Dose and Estimated Glomerular Filtration Rate (eGFR) Slope Changes in Patients With Diabetic Kidney Disease: A Real-World Retrospective Study.
BibTeX
@article{alayyannur2026kidney,
title = {{Kidney Health Biomarkers and Estimated Glomerular Filtration Rate Among Indonesian Tofu Production Workers: A Pilot Cross-Sectional Study.}},
author = {Putri Ayuni Alayyannur and Yustinus Denny Ardyanto Wahyudiono and Addien Nadira and Ritwan Agus Prasetyo and Edza Aria Wikurendra},
journal = {Health science reports},
year = {2026},
month = oct,
doi = {10.1002/hsr2.73431},
url = {https://europepmc.org/article/MED/42953470},
note = {CC BY},
}
RIS
TY - JOUR
TI - Kidney Health Biomarkers and Estimated Glomerular Filtration Rate Among Indonesian Tofu Production Workers: A Pilot Cross-Sectional Study.
AU - Putri Ayuni Alayyannur
AU - Yustinus Denny Ardyanto Wahyudiono
AU - Addien Nadira
AU - Ritwan Agus Prasetyo
AU - Edza Aria Wikurendra
PY - 2026
DA - 2026/10/28
JO - Health science reports
DO - 10.1002/hsr2.73431
UR - https://europepmc.org/article/MED/42953470
AB - Small-scale food-production workers may experience heat strain, dehydration, and combustion-related exposures, but evidence on early kidney injury in these settings remains limited. This pilot study aimed to describe serum and urinary kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) profiles and to assess, exploratorily, whether these biomarkers discriminated an estimated glomerular filtration rate (eGFR)-defined kidney-function category among Indonesian tofu production workers. A cross-sectional complete-case analysis included 32 workers from small-scale tofu production units in East Java, Indonesia. Serum creatinine, serum and urinary KIM-1, and serum and urinary NGAL were measured using laboratory microplate-based assays. eGFR was calculated using the CKD-EPI creatinine equation; < 90 mL/min/1.73 m2 was a study-defined exploratory category, not a CKD diagnosis. Descriptive statistics, Mann-Whitney U tests, Spearman correlations, and receiver operating characteristic analysis with 2000-resample bootstrap 95% confidence intervals were performed. Ten of 32 workers (31.3%) had eGFR < 90 mL/min/1.73 m2, and four of 32 (12.5%) had serum creatinine above the laboratory threshold. Median KIM-1 and NGAL concentrations were lower in the eGFR < 90 group across all four biomarker measures. Discriminatory performance was limited, with area-under-the-curve values ranging from 0.327 to 0.416. Urinary KIM-1 and NGAL were analysed as absolute concentrations without urinary creatinine normalisation; hydration-related variation in urine concentration may have increased measurement variability and weakened observed associations and discrimination. With 32 workers and 10 eGFR < 90 observations, the AUC estimates are imprecise and not definitive measures of diagnostic performance. KIM-1 and NGAL showed limited discrimination of the study-defined eGFR < 90 category; this result does not indicate poor overall utility as tubular injury biomarkers. Larger exposure-informed studies should incorporate creatinine-normalised urinary biomarkers, albuminuria, repeated kidney-function measurements, and objective assessment of heat and nephrotoxic exposures.
SN - 2398-8835
ER -